CPT code 44203: Small bowel resection, each additional resection2026 Medicare rate & RVUs in North Carolina
Report 44203 for each additional laparoscopic small-intestine resection with anastomosis beyond the primary resection, together with 44202.
In North Carolina, Medicare pays $200.81 for 44203 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 44203 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 44203 covers
Code 44203 captures an additional laparoscopic resection and reconnection of small intestine during the same operative session as the primary small-bowel resection. Multiple separate diseased segments, such as skip areas of Crohn disease or separate ischemic segments, may require additional resections and anastomoses. General and colorectal surgeons typically perform this work in an operating room using laparoscopic access.
Report 44203 only with the primary procedure, 44202. Count additional resection-and-anastomosis work, not the length of bowel removed or the number of pathology specimens. The operative report should identify the laparoscopic approach and describe each additional small-bowel segment resected and reconstructed. CMS classifies 44203 as an add-on code: it is billed only with a primary procedure, and payment is within that procedure’s global period.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How North Carolina compares for 44203
Across 109 of 109 payment localities, the facility rate for 44203 runs from $189.87 in Wisconsin to $274.69 in Alaska. North Carolina pays $200.81. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$200.81
- Los Angeles, CA · California$216.57+$15.76
- Washington, DC area · District of Columbia$234.31+$33.50
- Miami, FL · Florida$272.21+$71.40
- Chicago, IL · Illinois$263.58+$62.77
- Manhattan, NY · New York$252.09+$51.28
- Alaska · Alaska$274.69+$73.88
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $196.13 |
| ArkansasArkansas | — | $193.73 |
| ArizonaArizona | — | $209.85 |
| Bakersfield, CACalifornia | — | $208.31 |
| Chico, CACalifornia | — | $205.41 |
| El Centro, CACalifornia | — | $205.59 |
| Fresno, CACalifornia | — | $205.41 |
| Hanford, CACalifornia | — | $205.41 |
| Madera, CACalifornia | — | $205.41 |
| Merced, CACalifornia | — | $205.41 |
| Modesto, CACalifornia | — | $205.41 |
| Napa, CACalifornia | — | $219.00 |
| Oxnard, CACalifornia | — | $213.18 |
| Redding, CACalifornia | — | $205.41 |
| Rest of CaliforniaCalifornia | — | $205.41 |
| Riverside, CACalifornia | — | $216.88 |
| Sacramento, CACalifornia | — | $210.55 |
| Salinas, CACalifornia | — | $209.69 |
| San Diego, CACalifornia | — | $211.08 |
| Marin County, CACalifornia | — | $225.16 |
| San Francisco, CACalifornia | — | $223.95 |
| San Benito County, CACalifornia | — | $231.23 |
| Santa Clara County, CACalifornia | — | $226.26 |
| San Luis Obispo, CACalifornia | — | $206.95 |
| Santa Cruz, CACalifornia | — | $210.24 |
| Santa Maria, CACalifornia | — | $209.50 |
| Santa Rosa, CACalifornia | — | $212.01 |
| Stockton, CACalifornia | — | $205.41 |
| Vallejo, CACalifornia | — | $217.25 |
| Visalia, CACalifornia | — | $205.41 |
| Yuba City, CACalifornia | — | $205.41 |
| ColoradoColorado | — | $212.30 |
| ConnecticutConnecticut | — | $229.25 |
| DelawareDelaware | — | $212.79 |
| Fort Lauderdale, FLFlorida | — | $245.45 |
| Rest of FloridaFlorida | — | $232.51 |
| Atlanta, GAGeorgia | — | $224.29 |
| Rest of GeorgiaGeorgia | — | $219.11 |
| Hawaii, Guam, HIHawaii | — | $205.95 |
| IowaIowa | — | $191.52 |
| IdahoIdaho | — | $194.41 |
| East St. Louis, ILIllinois | — | $249.48 |
| Rest of IllinoisIllinois | — | $233.12 |
| Suburban Chicago, ILIllinois | — | $245.67 |
| IndianaIndiana | — | $195.13 |
| KansasKansas | — | $194.95 |
| KentuckyKentucky | — | $209.10 |
| New Orleans, LALouisiana | — | $218.86 |
| Rest of LouisianaLouisiana | — | $210.49 |
| Metropolitan Boston, MAMassachusetts | — | $225.04 |
| Rest of MassachusettsMassachusetts | — | $213.06 |
| Baltimore area, MDMaryland | — | $229.50 |
| Rest of MarylandMaryland | — | $215.05 |
| Rest of MaineMaine | — | $199.74 |
| Southern Maine, MEMaine | — | $202.59 |
| Detroit, MIMichigan | — | $239.37 |
| Rest of MichiganMichigan | — | $217.60 |
| MinnesotaMinnesota | — | $191.98 |
| Metropolitan Kansas City, MOMissouri | — | $213.10 |
| Metropolitan St. Louis, MOMissouri | — | $214.46 |
| Rest of MissouriMissouri | — | $210.24 |
| MississippiMississippi | — | $201.81 |
| MontanaMontana | — | $216.03 |
| North DakotaNorth Dakota | — | $194.87 |
| NebraskaNebraska | — | $191.12 |
| New HampshireNew Hampshire | — | $213.10 |
| Northern New JerseyNew Jersey | — | $233.36 |
| Rest of New JerseyNew Jersey | — | $228.64 |
| New MexicoNew Mexico | — | $220.32 |
| NevadaNevada | — | $210.17 |
| NYC suburbs and Long Island, NYNew York | — | $262.74 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $233.51 |
| Queens, NYNew York | — | $247.66 |
| Rest of New YorkNew York | — | $203.70 |
| OhioOhio | — | $213.28 |
| OklahomaOklahoma | — | $204.31 |
| Portland, OROregon | — | $213.24 |
| Rest of OregonOregon | — | $205.35 |
| Metropolitan Philadelphia, PAPennsylvania | — | $227.07 |
| Rest of PennsylvaniaPennsylvania | — | $211.21 |
| Puerto RicoPuerto Rico | — | $215.96 |
| Rhode IslandRhode Island | — | $216.17 |
| South CarolinaSouth Carolina | — | $208.03 |
| South DakotaSouth Dakota | — | $192.37 |
| TennesseeTennessee | — | $196.30 |
| Austin, TXTexas | — | $214.39 |
| Beaumont, TXTexas | — | $210.35 |
| Brazoria, TXTexas | — | $209.08 |
| Dallas, TXTexas | — | $212.19 |
| Fort Worth, TXTexas | — | $212.29 |
| Galveston, TXTexas | — | $210.86 |
| Houston, TXTexas | — | $230.45 |
| Rest of TexasTexas | — | $210.81 |
| UtahUtah | — | $210.31 |
| VirginiaVirginia | — | $204.99 |
| Virgin Islands, VIUnited States Virgin Islands | — | $215.96 |
| VermontVermont | — | $198.09 |
| Rest of WashingtonWashington | — | $211.34 |
| King County, WAWashington | — | $224.91 |
| WisconsinWisconsin | — | $189.87 |
| West VirginiaWest Virginia | — | $226.83 |
| WyomingWyoming | — | $206.81 |
44203 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 44203 rate is calculated
Each of 44203’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 44203
RVUs × geographic indexes × conversion factor
Work4.33
4.33 RVUs× 1.000 GPCI
Practice expense1.07
1.07 RVUs× 1.000 GPCI
Malpractice1.07
1.07 RVUs× 1.000 GPCI
Adjusted RVUs
6.4700
Conversion factor
$33.4009
Medicare rate
$216.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact North Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,367
- Code
- 44203
- Physician work
- 4.33
- Practice expense
- 1.07
- Malpractice
- 1.07
GPCI2026.csv
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.33 | × 1.000 | 4.3300 |
| Practice expense | 1.07 | × 0.933 | 0.9983 |
| Malpractice | 1.07 | × 0.639 | 0.6837 |
| Total RVUs | 6.0120 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, North Carolina$200.81
Facility: (4.33 × 1 + 1.07 × 0.933 + 1.07 × 0.639) × $33.4009 = $200.81
Payment rules and modifiers for 44203
The CMS indicators that decide how 44203 is paid alongside other services.
CMS payment indicators · 44203
Small bowel resection, each additional resection
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
44203 without 80 · national facility
$216.10
Small bowel resection, each additional resection
44203-80 · Assistant: 16%
$34.58
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
How 44203 has changed in North Carolina
44203 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $200.81 | RVU26D |
| 2026-07-01 | Not available in this setting | $200.81 | RVU26C |
| 2026-04-01 | Not available in this setting | $200.81 | RVU26B |
| 2026-01-01 | Not available in this setting | $200.81 | RVU26A |
| 2025-10-01 | Not available in this setting | $216.09 | RVU25D |
| 2025-07-01 | Not available in this setting | $216.09 | RVU25C |
| 2025-04-01 | Not available in this setting | $216.09 | RVU25B |
| 2025-01-01 | Not available in this setting | $216.09 | RVU25A |
| 2024-10-01 | Not available in this setting | $221.28 | RVU24D |
| 2024-07-01 | Not available in this setting | $221.28 | RVU24C |
| 2024-04-01 | Not available in this setting | $221.28 | RVU24B |
| 2024-03-09 | Not available in this setting | $221.28 | RVU24AR |
| 2024-01-01 | Not available in this setting | $217.67 | RVU24A |
| 2023-10-01 | Not available in this setting | $229.26 | RVU23D |
| 2023-07-01 | Not available in this setting | $229.26 | RVU23C |
| 2023-04-01 | Not available in this setting | $229.26 | RVU23B |
| 2023-01-01 | Not available in this setting | $229.26 | RVU23A |
| 2022-10-01 | Not available in this setting | $235.47 | RVU22D |
| 2022-07-01 | Not available in this setting | $235.47 | RVU22C |
| 2022-04-01 | Not available in this setting | $235.47 | RVU22B |
| 2022-01-01 | Not available in this setting | $235.47 | RVU22A |
| 2021-10-01 | Not available in this setting | $235.71 | RVU21D |
| 2021-07-01 | Not available in this setting | $235.71 | RVU21C |
| 2021-04-01 | Not available in this setting | $235.71 | RVU21B |
| 2021-01-01 | Not available in this setting | $235.71 | RVU21A |
| 2020-10-01 | Not available in this setting | $240.17 | RVU20D |
| 2020-07-01 | Not available in this setting | $240.17 | RVU20C |
| 2020-04-01 | Not available in this setting | $240.17 | RVU20B |
| 2020-01-01 | Not available in this setting | $240.17 | RVU20A |
| 2019-10-01 | Not available in this setting | $236.40 | RVU19D |
| 2019-07-01 | Not available in this setting | $236.40 | RVU19C |
| 2019-04-01 | Not available in this setting | $236.40 | RVU19B |
| 2019-01-01 | Not available in this setting | $236.40 | RVU19A |
| 2018-10-01 | Not available in this setting | $239.90 | RVU18D |
| 2018-07-01 | Not available in this setting | $239.90 | RVU18C |
| 2018-04-01 | Not available in this setting | $239.90 | RVU18B |
| 2018-01-01 | Not available in this setting | $239.90 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $238.36 | RVU17D |
| 2017-07-01 | Not available in this setting | $238.36 | RVU17C |
| 2017-04-01 | Not available in this setting | $238.36 | RVU17B |
| 2017-01-01 | Not available in this setting | $238.36 | RVU17A |
| 2016-10-01 | Not available in this setting | $239.14 | RVU16D |
| 2016-07-01 | Not available in this setting | $239.14 | RVU16C |
| 2016-04-01 | Not available in this setting | $239.14 | RVU16B |
| 2016-01-01 | Not available in this setting | $239.14 | RVU16A |
| 2015-10-01 | Not available in this setting | $241.93 | RVU15D |
| 2015-07-01 | Not available in this setting | $241.93 | RVU15C |
| 2015-04-01 | Not available in this setting | $240.73 | RVU15B |
| 2015-01-01 | Not available in this setting | $240.73 | RVU15A |
| 2014-10-01 | Not available in this setting | $235.31 | RVU14D |
| 2014-07-01 | Not available in this setting | $235.31 | RVU14C |
| 2014-04-01 | Not available in this setting | $235.31 | RVU14B |
| 2014-01-01 | Not available in this setting | $235.31 | RVU14A |
| 2013-10-01 | Not available in this setting | $227.62 | RVU13D |
| 2013-07-01 | Not available in this setting | $227.62 | RVU13C |
| 2013-04-01 | Not available in this setting | $227.62 | RVU13B |
| 2013-01-01 | Not available in this setting | $227.62 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
44203 billing questions
When is 44203 reported instead of 44202?
44202 represents the primary laparoscopic small-bowel resection with anastomosis. Report 44203 for each additional resection and anastomosis performed in that operative session.
Can 44203 be billed by itself?
No. It is an add-on code and must be reported with the primary procedure, 44202.
Are units based on bowel length or specimen count?
No. The code describes additional resection-and-anastomosis work. The operative report should support each additional resection and reconstruction.
What documentation supports an additional unit?
Document the laparoscopic approach, the additional small-bowel segment removed, and the anastomosis performed for that segment.
How does the global-period payment rule affect 44203?
CMS pays this add-on within the primary procedure’s global period. It is not billed apart from the qualifying primary procedure.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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